I almost always have my patient raise whichever toes that they have left. I thought the examination was to look for claudication in the digits..? Because here in Texas we are very thorough. I mean what good do "heel raises" do? All the criterias have been set for treadmill walking just like all the carotid velocity correlation was done at 60 degrees ONLY. There can not be any deviation from set criteria.

Jeremy Orlikoski

> On Sep 3, 2014, at 9:07 PM, "William OKeefe" <[log in to unmask]> wrote:
> 
> Really....are they really "toe-ups"?   Come on guys, do you stand there and watch your patients raise and lower their toes?
> The maneuver is called heel raises.
> Not getting' on you Steve....
> 
> William O'Keefe
> St. Mary's Hospital 
> Heart & Vascular Center
> Duluth, Minnesota
> 
> 
>  
> 
> 
>> On Wed, Sep 3, 2014 at 8:47 PM, Steven Knight <[log in to unmask]> wrote:
>> I don't believe that the provacative maneuvres mentioned in the 93923 CPT description refer to toe ups but to thoracic outlet testing. To be safe, I would stick to 93922 (single level).
>> 
>> Steve Knight BSc RVT RDCS
>> CVI Vascular Lab
>> Division of Vascular and Endovascular Surgery
>> Beth Israel Deaconess Medical Center
>> 110 Francis Street, Ste 5B
>> Boston, MA
>> 02215
>> 
>> Direct line: 617-632-9962
>> [log in to unmask]
>> ________________________________________
>> From: UVM Flownet [[log in to unmask]] On Behalf Of Nancy Williams [[log in to unmask]]
>> Sent: Wednesday, September 03, 2014 3:24 PM
>> To: [log in to unmask]
>> Subject: Re: ABI WITH EXERCISE
>> 
>> 93923 actually reads: Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental blood pressure measurements with bidirectional Doppler waveform recording and analysis, at 3 or more levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental volume plethysmography at 3 or more levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental transcutaneous oxygen tension measurements at 3 or more levels), or single level study with provocative functional maneuvers (eg, measurements with postural provocative tests, or measurements with reactive hyperemia)
>> 
>> We utilize the 93923 code for these ABI’s with toe raises (provocative maneuvers) as well.
>> 
>> From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Audrey Fleming
>> Sent: Wednesday, September 03, 2014 3:13 PM
>> To: [log in to unmask]
>> Subject: Re: ABI WITH EXERCISE
>> 
>> Why would you charge a multi-level for a post exercise ABI?
>> 
>> From: Steve Flieder <[log in to unmask]<mailto:[log in to unmask]>>
>> To: [log in to unmask]<mailto:[log in to unmask]>
>> Sent: Wednesday, September 3, 2014 3:02 PM
>> Subject: Re: ABI WITH EXERCISE
>> 
>> 93923....multi-level physiologic
>> 
>> Steve Flieder
>> Lifeline Vascular Access
>> Three Hawthorn Parkway
>> Vernon Hills, IL 60061
>> 
>> Phone:  617-510-2190
>> [log in to unmask]<mailto:[log in to unmask]>
>> 
>> P Go Green!  Please print this e-mail only if completely necessary
>> 
>> This email and the documents accompanying it may contain confidential information belonging to the sender that may be legally
>> privileged. This information is intended only for the use of the individual or entity named above. The authorized recipient of this
>> confidential information is prohibited from disclosing this information to any other party. If you have received this transmission in error, please delete from any computer.
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>> 
>> From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Audrey Fleming
>> Sent: Wednesday, September 03, 2014 1:45 PM
>> To: [log in to unmask]<mailto:[log in to unmask]>
>> Subject: Re: ABI WITH EXERCISE
>> 
>> There is no CPT code for toe-ups or hall walking.
>> 
>> From: Patricia Rudibaugh <[log in to unmask]<mailto:[log in to unmask]>>
>> To: [log in to unmask]<mailto:[log in to unmask]>
>> Sent: Wednesday, September 3, 2014 1:43 PM
>> Subject: ABI WITH EXERCISE
>> 
>> After seeing that CPT code 93924 cannot be used for hallway walking or "toe-up" exercise, only treadmill or hyperemia when completing an ABI with exericse test, does anyone still use the toe-up technique? If so, which CPT code is used?
>> 
>> 
>> Thanks in advance
>> 
>> Patty
>> 
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> 
> -- 
> Best regards,
> 
> William O'Keefe
> Frenel Solutions
> 830-643-4637 v
> 866-376-6645 f
> www.frenelsolutions.com
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